340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PREMIER PHARMACY SERVICES
DSH330127 JACOBI MEDICAL CENTER (NYCHHC)
Print
Covered Entity Details
Entity Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
FORMERLY BRONX MUNICIPAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH330127
Entity Address
1400 PELHAM PKWY SOUTH
BRONX, NY 10461
Medicare Provider Number
330127
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
PREMIER PHARMACY SERVICES
Pharmacy Address
410 CLOVERLEAF DR
BALDWIN PARK, CA 91706
Pharmacy Comments
Contract Details
Approval Date
4/18/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/5/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Good Health, Inc
Todd Weber, Director, Government Programs & Strategic Initiatives
(203) 212-4717
Signed By Date
4/18/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session